Indian hospitals are showing a growing incidence of Deep-Vein Thrombosis which is a form of Venous Thromboembolism (VTE). This was revealed in the Indian Observational Survey Of Venous- Thromboembolism Risk and Prophylaxis in the Acute Care Hospital setting supported by an unconditional grant from sanofi-aventis Group (India).
VTE is a blood clot which occurs in vein and the most common manifestations is Deep-Vein Thrombosis (DVT), usually in the leg. Symptoms include cramps, leg pain and swelling. When the clot breaks it travels to the lungs, blocks the blood vessel causing a fatal condition, Pulmonary Embolism (PE).
The study of 7,481 hospitalized patients from 46 hospitals across 11 states showed 67 per cent of were at risk of DVT and only 19 per cent of these patients were given any kind of prophylaxis (to prevent). The southern states showed highest rate of DVT prophylaxis and the North-East region the least.
VTE is no longer a rarity in India. Morbidity and mortality from VTE are a significantly underestimated; as 80 per cent of the disease is asymptomatic and hospitalized patients are amongst the highest at risk of DVT. Thromboprophylaxis is a common error of omission in hospitalised patients, the survey reported.
The INDORSE survey also aimed to determine the rate of prophylaxis based age, immobilization, obesity; and disease-related aspects like sepsis, stroke and major surgery. The ACCP (American College of Chest Physicians) guidelines also consider Sepsis and Stroke as independent risk factors for DVT.
The rate of DVT prophylaxis was lower than the ACCP recommended guidelines considering sepsis and stroke as a risk factor. At least 98 per cent of the patients screened, age was considered as the most common risk factor for DVT prophylaxis, 60 per cent of the patients were between 40 and 70 of age with a low prophylaxis rate of 20 per cent. The data showed the discrepancy with regards to DVT prophylaxis in India as compared to Western countries.
“We thus need to put in concerted efforts to improve patient safety in hospital through thromboprophylaxis”, stated Dr Muruga Vadivale, senior director, Medical & Regulatory, Group Sanofi-Aventis.
According to Dr U V Rao, Vascular surgeon, Manipal Hospital, Bangalore, it is also critical to consider sepsis, stroke, cancer and major surgery as predominant risk factors for DVT prophylaxis which would help reduce the incidence of VTE in India.
Dr Bhagvan, senior vascular surgeon, Manipal hospital opined that awareness of the condition is still not satisfactory amongst the public and medical community and more needs to be done to prevent the complication.